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Network Development Representative
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Job Title:
Network Development Representative
Job Ref No:
R223402
Location:
Florida
City:
Temple Terrace
Job Description:
It's fun to work in a company where people truly BELIEVE in what they're doing!
We're committed to bringing passion and customer focus to the business.
The Network Development Representative is responsible for assisting in the developing, maintaining and servicing a high quality, marketable and satisfied provider network within an assigned geographic area for Chapter Health System's Population Health Division in CareNU. Key responsibilities include recruitment and contracting; education and servicing of assigned providers by assisting providers to operate successfully within the Organization's healthcare delivery model including providing strategic planning and tools to meet goals. Accountable for overall performance and profitability for the assigned groups as well as ownership and oversight to provide redirection as appropriate.
Qualifications: • Bachelor's degree in a related field; or an equivalent combination of education and experience • A minimum of two (2) years of provider relations or managed care experience • Professional provider relations experience involving physicians and administrative staff preferred • Significant understanding of medical care financing and delivery systems, provider contracting, reimbursement arrangements and network management preferred • Provider recruitment and contracting experience preferred • Exceptional interpersonal skills with the ability to interface effectively both internally and externally with a wide range of people including physicians, office staff, hospital executives, and other health plan staff • Excellent analytical and problem solving skills with effective follow through • Strong verbal and written communication skills including presentation skills to small and large groups • Solid knowledge of local provider community • Mobile Driver - Valid driver's license and automobile insurance per Company policy • Ability to travel to off-site locations Competencies: • Satisfactorily complete competency requirements for this position. Responsibilities of all employees: • Represent the Company professionally at all times through care delivered and/or services provided to all clients. • Comply with all State, federal and local government regulations, maintaining a strong position against fraud and abuse. • Comply with Company policies, procedures and standard practices. • Observe the Company's health, safety and security practices. • Maintain the confidentiality of patients, families, colleagues and other sensitive situations within the Company. • Use resources in a fiscally responsible manner. • Promote the Company through participation in community and professional organizations. • Participate proactively in improving performance at the organizational, departmental and individual levels. • Improve own professional knowledge and skill level. • Advance electronic media skills. • Support Company research and educational activities. • Share expertise with co-workers both formally and informally. • Participate in Quality Assessment and Performance Improvement activities as appropriate for the position. Job Responsibilities: • Develops and maintains relationships with local providers to ensure network adequacy. Introduces and advocates Chapters Health System and the affiliates to local provider networks via informational summits and events. • Conducts new provider orientations, ensuring providers and staff have in-depth understanding of contractual obligations, program incentives, and patient care best practices to facilitate practice optimization. • Maintains open dialog with providers to ensure they have the tools needed to resolve issues including quality, risk adjustment, and sustainable growth per business development plans. • Meets regularly with cross-functional teams to create, revise and adjust overall strategic plans based on detailed analysis of various reports. • Coordinates provider meetings to share and discuss economic data, issues related to credentialing, claims, eligibility, disease management, utilization management, and quality and risk adjustment programs. Meetings to include scheduling, agenda, materials, location, food, and minutes. • In conjunction with the predictive analytics staff and the Medical Director, collaborates with provider groups to develop, execute and monitor performance and patient outcomes improvement plans. • Collaborates with the predictive analytics staff and the Medical Director to monitor utilization trends and profit pools and shares results with assigned Physicians. • Collaborates with contracting team to ensure provider data is correct and provider directories include any needed updates. Completes Practitioner Data Forms and Provider Change Forms. • Provider support to maintain and develop ongoing value related to the CareNu Value Proposition. • Identifies at risk situations and develops a plan for escalation and corrective actions. • Performs other duties as assigned.
Employer:
Chapters Health System .
Post Date:
05/08/2022
Apply Details:
https://chaptershealth.wd5.myworkdayjobs.com/en-US/jobs/details/Network-Development-Representative_R223402
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